Lorella Palazzo

Kaiser Permanente Washington Health Research Institute

Lung cancer is the leading cause of cancer morbidity and mortality in the United States. Annual screening with low-dose computed tomography (LDCT) reduces lung cancer mortality. However, annual adherence to screening is suboptimal. To improve annual adherence to lung cancer screening (LCS), additional patient education beyond shared-decision making...

Background Implementation strategies are theorized to work well when carefully matched to implementation determinants and when factors—preconditions, moderators, etc.—that influence strategy effectiveness are prospectively identified and addressed. Existing methods for strategy selection are either imprecise or require significant technical experti...

People choose how and if to generate and disclose not just personal genomic data, but also multiple other types of personal health and non-health related data. To contextualize choices about genetic testing and genetic data disclosure, we explored perspectives of genomic data privacy and disclosure compared to other types of data. We conducted a qu...

The authors examine the origin, benefits, and challenges of pragmatic clinical trials to assess the ultimate value of this research design.

Background Early detection of dementia may improve patient care and quality of life, yet up to half of people with dementia are undiagnosed. Electronic health record (EHR) data could be used to help identify individuals at risk of having undiagnosed dementia for outreach and assessment, but acceptability to people with dementia and caregivers is un...

Introduction Limited evidence-based implementation strategies exist for maintaining lung cancer screening. We evaluated the Lung Cancer Screening Program at Kaiser Permanente Washington (KPWA) to develop multilevel interventions to improve screening adherence. Methods We conducted a concurrent mixed-methods study 1) to measure adherence to repeat...

BACKGROUND Early detection of dementia may improve patient care and quality of life, yet as many as half of patients are undiagnosed. Electronic health record (EHR) data could potentially be used to help to identify patients at risk of having undiagnosed dementia who could be targeted for outreach and assessment, but acceptability to patients and c...

Background: Evidence-based interventions (EBIs) could reduce cervical cancer deaths by 90%, colorectal cancer deaths by 70%, and lung cancer deaths by 95% if widely and effectively implemented in the USA. Yet, EBI implementation, when it occurs, is often suboptimal. This manuscript outlines the protocol for Optimizing Implementation in Cancer Cont...

Introduction: Kaiser Permanente (KP) Mid-Atlantic States has partnered with communities in its service area since 2011 to provide health services to underserved individuals. As part of KP's Community Benefit investment, the Community Ambassador Program places KP advanced-practice clinicians in safety-net clinics to share best practices and to impr...

In 2014, the US Preventive Task Force recommended annual lung cancer screening with low dose CT (LDCT) for adults aged 55 to 80 years old with significant smoking history. Although screening reduces lung cancer mortality, the leading cause of cancer mortality in the US, adherence to screening follow-up remains low. In a human-centered design qualit...

Background: Multiple sclerosis (MS) is associated with high total health care cost, the majority of which is attributable to medications. Patients with MS are less likely to experience relapses, emergency department (ED) visits, and hospitalizations when they are adherent to disease-modifying treatments. Disease management programs are hypothesize...

Scholars studying religion as a social institution have struggled to explain two contradictory trends. Secularization theory posits America as increasingly less religious, yet religious participation and other indicators of spirituality remain high. Our study provides information critical to this debate by employing national data collected over a 2...